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乳腺癌幸存女性的预防保健与筛查依从性

Preventive Care and Screening Adherence Among Women Surviving Breast Cancer.

作者信息

Zisa Anthony J, Statman Muriel R, Sleiman Marcelo M, Liu Duye, Fleischmann Adina, Tercyak Kenneth P

机构信息

Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC 20007, USA.

Sharsheret, Teaneck, NJ 07666, USA.

出版信息

Cancers (Basel). 2025 Aug 29;17(17):2837. doi: 10.3390/cancers17172837.

Abstract

: Routine preventive care, including physical examinations, mammography, and cervical cancer screening, is critical for long-term health maintenance and recurrence surveillance among breast cancer survivors. Community-based organizations (CBOs) may play a key role in supporting adherence to these services through education, navigation, and survivorship care planning. : A secondary analysis was conducted using data from = 777 breast cancer survivors who contacted a national cancer-focused CBO for resources, including no-cost patient navigation. Preventive care adherence was measured via a composite index based on self-reported receipt of physical exams, mammograms, and Pap smears at guideline-recommended intervals. Patient-reported outcomes were assessed 30 days post-contact, including Survivorship Care Planning (SCP) receipt and quality of life (QoL). : Adherence to all three guideline-based screenings was reported by 66% of BCS, 29% adhered to two, and 6% to one or fewer. Physical exams had the highest adherence rate (97%), followed by mammograms (88%) and Pap smears (73%). Bivariate analyses showed higher adherence among younger survivors (t = 4.59, df = 711, < 0.001), non-white survivors (t = -3.27, df = 267, < 0.001), those in partnered relationships (t = 1.76, df = 54, < 0.05), and individuals with better QoL (r = -0.09, < 0.01). Receipt of SCP components was associated with a trend toward improved adherence: 56% received a care summary, 64% received follow-up instructions, and 45% received written materials (r = 0.05, < 0.10). In multivariable regression adjusting for partnership status and SCP receipt, younger age (B = 1.13, < 0.001), non-white race/ethnicity (B = 1.00, < 0.01), and higher QoL scores (B = 0.09, < 0.05) were significantly associated with greater adherence. : Engagement with a CBO was associated with high levels of adherence to preventive care among breast cancer survivors-especially those who were younger, non-white, and with better QoL. SCP, particularly when delivered in written form with follow-up instructions, may support improved adherence. These findings highlight the value of CBO-led survivorship support in promoting long-term health maintenance for breast cancer survivors.

摘要

常规预防性护理,包括体格检查、乳房X光检查和宫颈癌筛查,对于乳腺癌幸存者的长期健康维护和复发监测至关重要。社区组织(CBOs)可能通过教育、引导和生存护理规划,在支持患者坚持接受这些服务方面发挥关键作用。

使用来自777名乳腺癌幸存者的数据进行了二次分析,这些幸存者联系了一家全国性的专注于癌症的CBO以获取资源,包括免费的患者引导服务。通过基于自我报告在指南推荐间隔接受体格检查、乳房X光检查和巴氏涂片检查情况的综合指数来衡量预防性护理的依从性。在接触后30天评估患者报告的结果,包括生存护理规划(SCP)的接受情况和生活质量(QoL)。

66%的乳腺癌幸存者报告坚持了所有三项基于指南的筛查,29%坚持了两项,6%坚持了一项或更少。体格检查的依从率最高(97%),其次是乳房X光检查(88%)和巴氏涂片检查(73%)。双变量分析显示,年轻幸存者(t = 4.59,自由度 = 711,P < 0.001)、非白人幸存者(t = -3.27,自由度 = 267,P < 0.001)、处于伴侣关系的人(t = 1.76,自由度 = 54,P < 0.05)以及生活质量较好的个体(r = -0.09,P < 0.01)的依从性更高。接受SCP组成部分与依从性改善的趋势相关:56%的人收到了护理总结,64%的人收到了随访指示,45%的人收到了书面材料(r = 0.05,P < 0.10)。在对伴侣关系状态和SCP接受情况进行调整的多变量回归分析中,年龄较小(B = 1.13,P < 0.001)、非白人种族/族裔(B = 1.00,P < 0.01)和较高的QoL分数(B = 0.09,P < 0.05)与更高的依从性显著相关。

与CBO的接触与乳腺癌幸存者对预防性护理的高度依从性相关,尤其是那些年龄较小、非白人且生活质量较好的幸存者。SCP,特别是以书面形式并带有随访指示提供时,可能有助于提高依从性。这些发现凸显了CBO主导的生存支持在促进乳腺癌幸存者长期健康维护方面的价值。

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